Impact of the Prognostic Nutritional Index on the Survival of Japanese Patients with Hepatocellular Carcinoma Treated with Sorafenib: A Multicenter Retrospective Study

Hatanaka, Takeshi; Kakizaki, Satoru; Uehara, Daisuke; Nagashima, Tamon; Ueno, Takashi; Namikawa, Masashi; Saito, Shuichi; Hosonuma, Kenichi; Suzuki, Hideyuki; Naganuma, Atsushi; Takagi, Hitoshi; Sato, Ken; Uraoka, Toshio

doi:10.2169/internalmedicine.1594-18

Cited by 12 publications

(10 citation statements)

References 40 publications

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“…Authors showed that PNI constituted an independent predictor of survival, 21 consistent with the results obtained by the Japanese research group of Hatanaka et al 30 Finally, Hiraoka et al 31 analyzed a cohort of HCC patients treated with lenvatinib and highlighted the strength of PNI in indicating the best nutritional status for introducing treatment with TKI, thus proposing the PNI as an easy-to-use nutritional assessment tool to implement in clinical practice, along with the ALBI score.…”

Section: Discussionsupporting

confidence: 58%

Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with regorafenib

Rimini

Yoo

Masi

et al. 2021

Hepatology Research

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Aim: A link has been established between malnutrition, immunological status, and hepatocellular carcinoma (HCC). The prognostic nutritional index (PNI) has been recognized as a prognostic indicator in early-stage HCC and in patients treated with first-line therapy. However, to date, the role of the PNI in HCC patients treated with regorafenib has not been reported. Methods:We undertook a multicentric analysis on a cohort of 284 patients affected by advanced HCC treated with regorafenib. The PNI was calculated as follows: 10 � serum albumin concentration (g/dl) + 0.005 � peripheral lymphocyte count (number/mm 3 ). Univariate and multivariate analyses were used to investigate the association between PNI and survival outcomes.Results: A PNI cut-off value of 44.45 was calculated by a receiver operating characteristic analysis. The median overall survival was 12.8 and 7.8 months for patients with high (>44.45) and low (≤44.45) PNI, respectively (hazard ratio, 0.58; 95%

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Section: Discussionsupporting

confidence: 58%

Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with regorafenib

Rimini

Yoo

Masi

et al. 2021

Hepatology Research

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“…In the Japanese experience of Hatanaka et al [42], the PNI was a significant factor associated with the duration of Sorafenib therapy and the OS among pre-treatment factors in a cohort of patients treated with Sorafenib. No significant differences in terms of Sorafenib efficacy and serious adverse events rate were found between high-and low-PNI groups.…”

Section: Plos Onementioning

confidence: 89%

“…The participants in a second validation cohort were 76 patients collected in the Innovate STUDY database [42]. Baseline clinical and laboratory characteristics are summarized in Table 3.…”

Section: Plos Onementioning

confidence: 99%

The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib

et al. 2020

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Background and aims The present study aims to investigate the role of the prognostic nutritional index (PNI) on survival in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. Methods This multicentric study included a training cohort of 194 HCC patients and three external validation cohorts of 129, 76 and 265 HCC patients treated with Sorafenib, respectively. The PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm 3). Univariate and multivariate analyses were performed to investigate the association between the covariates and the overall survival (OS). Results A PNI cutoff value of 31.3 was established using the ROC analysis. In the training cohort, the median OS was 14.8 months (95% CI 12-76.3) and 6.8 months (95% CI 2.7-24.6) for patients with a high (>31.3) and low (<31.3) PNI, respectively. At both the univariate and the multivariate analysis, low PNI value (p = 0.0004), a 1-unit increase of aspartate aminotransferase (p = 0.0001), and age > 70 years (p< 0.0038) were independent prognostic factors for OS. By performing the same multivariate analysis of the training cohort, the PNI <31.3

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“…It is reported to be a useful tool for assessing the preoperative condition and outcome of patients with gastrointestinal tumors [96]. Some studies have reported that the PNI is a prognostic factor in HCC patients receiving surgical treatment [97,98] or sorafenib treatment [99,100]. The PNI was strongly correlated with the ALBI score and the predictive cut-off values of the PNI for ALBI grade 1 and mALBI grade 2a were 39.0 and 36.0, respectively [101].…”

Section: Nutrition Assessment As a Prognostic Indicatormentioning

confidence: 99%

Lenvatinib for Hepatocellular Carcinoma: A Literature Review

2021

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Lenvatinib, which is an oral multikinase inhibitor, showed non-inferiority to the sorafenib in terms of overall survival (OS) and a higher objective response rate (ORR) and better progression-free survival (PFS) in patients with hepatocellular carcinoma (HCC). A good liver function and Barcelona Clinic Liver Cancer (BCLC) intermediate stage were the key factors in achieving therapeutic efficacy. The management of adverse events plays an important role in continuing lenvatinib treatment. While sequential therapies contributed to prolonging overall survival, effective molecular targeted agents for the administration after lenvatinib have not been established. Repeated transcatheter arterial chemoembolization (TACE) was associated with a decline in the liver function and poor therapeutic response in BCLC intermediate patients. Recently, the Asia-Pacific Primary Liver Cancer Expert (APPLE) Consensus Statement proposed the criteria for TACE unsuitability. Upfront systemic therapy may be better for the BCLC intermediate stage HCC patients with a high tumor burden, while selective TACE will be recommended for obtaining a curative response in patients with a low tumor burden. This article reviews the therapeutic response, management of adverse events, post-progression treatment after Lenvatinib, and treatment strategy for BCLC intermediate stage HCC.

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Impact of the Prognostic Nutritional Index on the Survival of Japanese Patients with Hepatocellular Carcinoma Treated with Sorafenib: A Multicenter Retrospective Study

Cited by 12 publications

References 40 publications

Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with regorafenib

Role of the prognostic nutritional index in predicting survival in advanced hepatocellular carcinoma treated with regorafenib

The role of PNI to predict survival in advanced hepatocellular carcinoma treated with Sorafenib

Lenvatinib for Hepatocellular Carcinoma: A Literature Review

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